What are your strategies for finding the best doctor (or at least a very good doctor) for a particular procedure?

I have a condition that may end up needing surgery. I live in a small enough city and my current doctor has been unhelpful enough in diagnosing the condition that I'm not at all confident I would want to have the surgery done here in town by the one person who specializes in it. Plus this surgery would require me to have someone to help out during a few weeks of recovery, which means that it would probably make the most sense to have it done in a large city where I have family and where there is a major, high-quality set of hospitals.

I have excellent google skills, but what should I be looking for to help me wade through the results? And how does getting in touch with the doctors I'm interested in work once I have a particular diagnosis/test results from my doctor at home? I'm looking for someone who's done this before to walk me through the steps I'd need to take. If it matters, I'd be looking for a colo-rectal surgeon in Houston, TX, but feedback from anyone who has done this kind of search for a doctor for any condition would be helpful.

Do you or any of your family/friends (or their family/friends) know any nurses, doctors, PA's, etc. in Houston? Ask them (or have them ask their church buddy or fellow PTA parent or whatever) who they themselves would see, or would send their own family member to. Then you (ideally) have your primary care person send over the referral to their office.posted by blue suede stockings at 1:55 PM on March 28, 2014 [1 favorite]

As a starting point, I'd say get a list of every colo-rectal surgeon in Houston, TX you can find, and enter their names one by one in Google. Pay attention to the ones who have patient ratings on Zocdoc, Yelp, Health Grades, etc. Ignore the ones who don't get rated, or who have bad ratings. Focus on the ones who have high ratings, and dig into their backgrounds a bit. Pay more attention to written reviews than star ratings.

I've done my own doctor searching recently, and it's surprising how often somebody who sounds great on paper has a long, long list of truly horrifying patient reviews.

Also, when you visit the doctor's office, pay attention to the cleanliness of the place and the quality of the magazines in the waiting room. ESPECIALLY the magazines. They say a lot about how much the doctor cares for his patients. A grungy waiting room with nothing to read but old golf magazines tells you a lot about the doctor before you even meet him.posted by Ursula Hitler at 2:00 PM on March 28, 2014

People always say to ask friends for physician referrals or look at review sites, but I posit that is a bad strategy.
• People have a very limited knowledge of the range of physicians available.
• Patients often prefer "likeable" doctors at the expense of the excellent clinicians.
• Review sites are tremendously skewed toward the dissatisfied and that's often based on likeability. (He was rude. I didn't like office manager. Horrible bedside.) Ideally, you find a excellent practitioner who's also an excellent communicator. If you can only have one or the other, then rank skill over personality.

I'd look for faculty surgeons at the best university hospital in your area. There's a likelihood that surgical residents will be active in your surgery and care. That's offset by having a surgeon who's teaching and up-to-speed on the most recent literature/technique. Also, university surgeon's have an active M&M and are consistently studying what went wrong in an effort to improve patient outcomes.posted by 26.2 at 2:22 PM on March 28, 2014 [4 favorites]

I've done this twice with success.

Find the website of any local med schools, and look up the dean of the relevant department (proctology? I don't know.). Send them a short, polite email thanking them for their time and consideration, explain your situation in general terms and ask if they have any recommendations for surgeons they might recommend. Really, keep it short. No longer than this paragraph.

It might take a few days for them to get around to it, but the ones I've contacted seem happy to help. I ended up with excellent doctors.posted by cmoj at 2:28 PM on March 28, 2014 [4 favorites]

Yeah, to clarify, this is what I meant: ask friends and family who are nurses, doctors, or PAs who have served in the geographical area you're looking at, or have them ask any friends who are actual nurses, doctors, or PAs.posted by blue suede stockings at 3:04 PM on March 28, 2014

One of the best pieces of advice I have heard for this, and I heard it on some other AskMe, was to find out where professional athletes were having their surgery done.

For the class of surgeries that directly effect athletic performance (lasik, foot work, etc) they're going to have a well developed grapevine of surgeons who do it right.posted by bswinburn at 3:33 PM on March 28, 2014

I needed a colorectal surgeon last year (on the off chance that you're seeking the same procedure as me, please feel free to MeMail if you're comfortable).

Here's how I found one:
- I sought recommendations from doctors I trusted. Like you, the doctor who diagnosed me kind of stunk, but I had a relationship with a great GP who knew enough to know good names
- I became VERY active on message boards for the condition/procedure I needed. Golly do people talk!
- I searched online to see which of those names had published research about this procedure, and how recently they had done so
- When I narrowed it down to a handful of surgeons (based on the above and based on insurance coverage), I scheduled consults with all of them. Their office staff will help you navigate what needs to be done in terms of sending records from your current doctor.
- During the consults, I asked them point blank how many procedures they had done and how often those procedures failed. The surgeon I ended up picking had performed my surgery over 700 times and it failed less than 15 of those times.
- I also asked for contact information for previous patients with my condition/procedure who would be willing to speak with me over the phone. I think many people don't realize that for major surgery this is normal, and the vast majority of surgeons will provide this info to prospective patients.

I've been extremely happy with my results and am now an evangelist for my surgeon (and the cycle continues). Unfortunately he's not in Houston or else I would recommend him directly.

I hope this helps, again, please feel free to MeMail!posted by telegraph at 3:40 PM on March 28, 2014

Things which impressed me: he's been a doctor for literally decades so he really takes the time to listen to the patient, which he combines with the research background and technical demands of a faculty surgeon. He's also the guy who other doctors call when they have a tricky question (which was hilarious to listen to as I was being prepped for surgery a month or two back). My two caveats are: he's really busy so I waited four hours extra to see him and secondly, he bills what he's worth and that gets expensive fast.

General recommendations on picking a doctor (that match a lot of what others already mentioned):
1) Get your networks going (Facebook, friends, MetaFilter, whatever)
2) Google specific doctors once you've got names
3) Do look for faculty at teaching hospitals (less relevant in Houston, because the Med Center is the world's largest and they're nearly all teaching hospitals)
4) I'm a researcher, so I look to see if they've published recently, what awards and honors they've won, what committees/journals/etc they take part in. In short, are they active in the field, and are they active in the area of the field which covers my problem?
5) Check to see how insurance feels about all this

Steps to take once you do pick a doc:
1) Call your insurance and see if your doctor of choice is covered and whether/what type of referral they need. Decide what to do if the doc is not in-network.
2) Call the doctor you currently work with and tell them you need your medical records to consult with another doctor. I put this second because it can take a while on their end.
3) Call the office of your doctor of choice and explain your sitch to the nurse. Dr Ertan has a whole Center of his own and the guy is busy, but he still goes through a scheduling assistant like every other doctor--and I'm guessing so do the other GIs in the Med Center.
4) Decide whether the appointment time is going to work for you (that is, is it too far out? Popular surgeons are likely to be booked out a ways, though in my case I saw Dr Ertan within three days because Reasons). This appointment will probably be the initial consultation rather than the actual surgery, so factor that into your plans for work, etc.
4) Price everything (medical billing, trip to see family, time off work) out. Are you happy with the final numbers? If the numbers add up and you have a good feeling about the doc and their office, go for it.posted by librarylis at 10:07 PM on March 28, 2014

Review sites are tremendously skewed toward the dissatisfied and that's often based on likeability.

Likeability isn't just about being nice. You need a doctor who gives a damn. Compassion and engagement are essential. If enough patients are saying a doctor just doesn't listen, or he's impossible to ever see, that matters more than where he went to school.posted by Ursula Hitler at 4:31 AM on March 29, 2014

A surgeon who is likable but unskilled will botch your surgery. A surgeon who is competent but lacking in charm will leave you unimpressed at the bedside, but medically whole.

Five, ten, fifteen years down the road you will likely never have had a second interaction with that surgeon. You'll have used your colon every day. Competency over charm.posted by 26.2 at 3:01 PM on March 29, 2014

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